Recent contract wins for Northrop Grumman and Booz Allen Hamilton aim to address the need for closer health care coordination between the Defense and Veterans Affairs departments.

Earlier this week, Northrop Grumman announced a $10.3 million DOD contract to continue work on the Clinical and Health Data Repository (CHDR), which seeks to ease the sharing of patient information between VA and DOD. DOD and VA last week disclosed a Booz Allen contract, which the departments billed as the first step in creating a joint inpatient electronic health record.

The projects arrive at a time of concern over the treatment of returning wounded service members and veterans. The President's Commission on Care for America's Returning Wounded Warriors issued its report last month, urging DOD and VA to continue their pursuit of an interoperable electronic health record system. Also last month, the Senate passed the Dignified Treatment of Wounded Warriors Act addressing the management of medical care.

The contract activity targets the transition in care as service members move from DOD health facilities to the VA system.

"What DOD and VA are striving for strategically is a true, seamless
sharing of information across this entire wounded warrior life cycle,"said Robin Portman, vice president at Booz Allen.

She said information sharing isn't focused exclusively on medical records but also on the disability determination process and the provision of benefits.

Under Booz Allen's contract, the company will work with VA and DOD to "determine the feasibility of having a common electronic medical records system and what it would look like," Portman said. Booz Allen will explore potential options for such a system and examine the costs and benefits of those options, she added.

Northrop Grumman's contract, meanwhile, focuses on the deployment of CHDR. CHDR synchronizes health data between DOD and VA, focusing on dual consumers, who receive care in DOD and VA facilities, said Les Westberg, senior software architect/engineer at Northrop Grumman Information Technology.

The CHDR system currently works with allergy and pharmacy data. Lab data will be included next.

CHDR interacts with DOD's Armed Forces Health Longitudinal Technology Application (AHLTA) electronic heath record system and the health data repository component of VA's Veterans Health Information Systems and Technology Architecture, or VistA.

In one scenario, a dual-consumer patient is identified and a request made to extract allergy and medicine data from the VA system. That data is stored in the AHLTA repository and flagged as coming from VA, Westberg said. Conversely, VA might request data from the AHLTA system and have that data extracted and stored on VistA's health data repository.

Northrop Grumman also works on the CHDR-Bidirectional Health Information Exchange (BHIE) project. CHDR-BHIE also orchestrates health data sharing between DOD and VA but is designed for viewing data. CHDR, in contrast, provides for the exchange of computable health data.

The CHDR-BHIE read-only system, however, "allows us to open up more data types" more quickly, Westberg said, noting that integration of computable data takes longer to accomplish.

Two weeks ago, CHDR-BHIE went live with medication, allergy, radiology and chemistry lab data. This system lets physicians at VA see if the DOD side has data on a given patient, or vice versa. The system uses attributes such as patient name and Social Security number to determine whether the DOD or VA system has information on a patient.

Westberg said the current task is to correlate patient data. He said the process of correlating patients common to DOD and VA will take 20 days.